| NPI | 1912506635 | 
|---|---|
| Doing Business As | HACKLEY COMMUNITY CARE CENTER MOBILE DENTAL | 
| Entity Type | Organization | 
| Authorized Contact | SHERI WEGLARZ COO 231-733-6610  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | 
| Enumeration Date | 2020-10-23 | 
| Last Update Date | 2020-10-23 |